Poor Sleep Quality and Sleep Apnea Occur Commonly in Elderly Japanese-American Men

Chicago, IL - June 7, 2001

Normative data about sleep architecture in the elderly have not been well characterized. The authors of this study resolved to investigate sleep architecture and its variation with sleep disordered breathing, using survivors of the Honolulu Heart Program who participated in the Honolulu-Asia Aging Study of Sleep Apnea.

The sleep characteristics of more than 600 very old (ranging from 79 to 97 years) Japanese-American men from the Honolulu-Asia Aging Study were studied using standardized, overnight, in-home sleep and breathing monitoring. Although other studies have demonstrated that sleep quality changes with aging, few studies have studied a large sample of very old individuals living in the community.

This study aimed to systematically describe sleep quality and its relationship to sleep apnea (a condition in which breathing is interrupted during sleep by brief pauses resulting form partial or complete closure of the throat) in men 79 years of age and older. The overall time spent in lighter (stage one and two) compared to deeper (slow-wave and REM, or "dreaming") sleep, was evaluated. Light sleep is generally considered less restorative than deep sleep.

It was found that sleep quality was generally poor among this population: on average, approximately 30 percent of the time in bed was spent awake rather than asleep. Relatively large amounts of time during the night were spent in light rather than in deep (slow-wave) or REM (rapid eye movement) sleep: 75 percent versus 25 percent, on average was spent in light (stage one and two) versus deep (slow-wave and REM) sleep, respectively. Almost six percent of the sample had no evidence of any deep (slow-wave) sleep. Additionally, a high frequency of sleep apnea was observed: almost 40 percent of the men had moderately frequent breathing pauses (more than 15 per hour) and 18 percent of the group had very frequent breathing pauses (more than 30 per hour.)

Men with relatively high numbers of breathing pauses (consistent with sleep apnea) had poorer sleep quality than men with fewer breathing pauses during sleep. Specifically, men with fewer breathing pauses had about twice as much slow wave sleep and three times as much REM sleep than men with sleep apnea.

This study shows that very old men living in the community often experience frequent breathing pauses during sleep, and those with the most breathing pauses have the poorest quality of sleep.

E. Larkin, D. Foley, K. Romaniuk, J. Arnold, S. Surovec and S. Redline were the researchers involved with this study, representing Case-Western Reserve University, the National Institute on Aging, and the University of Hawaii School of Medicine.